Background
Methods
Study design
Participant screening and protocol
Physical fitness evaluation
6 min walking test (6MWT)
Strength measurements
Body composition
Laboratory analysis
Metabolic parameters
Other blood examinations
Inflammatory markers
Soluble markers
Flow cytometry for cell-activation markers
Retention in study and adherence
Statistical analysis
Results
Patient disposition and baseline characteristics
All (n = 35) | Walk (n = 21) | Strength-Walk (n = 14) | |
---|---|---|---|
Demographic and general characteristics | |||
Male gendera
| 26 (74%) | 12 (57%)a
| 14 (100%)a
|
Age (years, median, Q1-Q3) | 48 (44–54) | 48 (43–54) | 49 (44–54) |
Caucasian race | 35 (100%) | 21 (100%) | 14 (100%) |
BMI (Kg/m2) | 25.6 (22.2-27.2) | 25.3 (21.6-27.5) | 25.8 (24.1-26.9) |
Risk Group | |||
Ex-intravenous drug users | 8 (23%) | 7 (33%) | 1 (7%) |
Men-having-sex-with-men | 21 (57%) | 7 (33%) | 13 (93%) |
Heterosexual infection | 6 (17%) | 6 (29%) | 0 |
Vertical infection | 1 (3%) | 1 (5%) | 0 |
HIV infection variables | |||
Previous AIDS-defining events | 9 (25%) | 7 (33%) | 2 (14%) |
Nadir CD4+ T-cells/μL (median, Q1-Q3) | 94 (37–197) | 80 (34–140) | 188 (77–258) |
Current CD4+ T-cells/μL (median, Q1-Q3) | 577 (406–726) | 485 (374–686) | 624 (527–740) |
VL < 40 c/mL | 34 (97%) | 21 (100%) | 13 (93%) |
Hepatitis C virus coinfection | 4 (11%) | 4 (19%) | 0 |
VACS Index | 12 (5–19) | 16 (6–24) | 9 (0–12) |
Smoking and Treatments | |||
Smokers | 8 (23%) | 6 (29%) | 2 (14%) |
2NRTI + Protease inhibitor | 14 (40%) | 7 (33%) | 7 (50%) |
2NRTI + NNRTI | 11 (31%) | 7 (33%) | 4 (29%) |
Other ART regimens | 10 (28%) | 7 (33%) | 3 (21%) |
Beta blockersb
| 6 (17%) | 5 (24%) | 1 (7%) |
Other anti-hypertensive drugsb
| 5 (14%) | 2 (10%) | 3 (21%) |
Statinsb
| 10 (29%) | 4 (19%) | 6 (42%) |
Fibratesb
| 2 (6%) | 0 | 2 (14%) |
Inclusion Criteria | |||
Lipodystrophy | 35 (100%) | 21 (100%) | 14 (100%) |
≥ 1 metabolic syndrome criterion | 32 (91%) | 19 (90%) | 13 (93%) |
Blood triglycerides ≥150 mg/dL | 14 (40%) | 8 (38%) | 6 (42%) |
Blood HDL-C ≤40 (m) or ≤50 (w) mg/dL | 12 (34%) | 9 (43%) | 3 (21%) |
Blood glucose ≥110 mg/dL | 1 (3%) | 0 | 1 (7%) |
Waist ≥102 (m) or ≥88 (w) cm | 10 (28%) | 8 (38%) | 2 (14%) |
SBP ≥150 or DBP ≥85 mmHg | 12 (34%) | 7 (33%) | 5 (36%) |
Physical fitness
Performance during the training sessions
All | Walk | Strength-walk | |
---|---|---|---|
Adherence (%) | 67 (58–75) | 61 (56–72) | 69 (63–79) |
Total walked distance (Km) | 122 (84–146) | 105c (73–139) | 136c (121–155) |
Total energy expenditure (KJ/Kg)a
| 298.18 (205.31-356.84) | 248.84 (173.00-329.84) | 344.67 (306.65-392.82) |
Walked distance/session (m) | 5040 (4380–5500) | 4740d (3535–5390) | 5330d (4980–5700) |
Energy expenditure per session (KJ/Kg)a
| 12.32 (10.10-14.28) | 11.23 (8.01-13.77) | 13.51 (12.09-15.25) |
HRmean (% of HRmax)b
| 66 (62–75) | 66 (58–73) | 70 (63–86) |
6MWT
All | Walk | Strength-Walk | |||||||
---|---|---|---|---|---|---|---|---|---|
BL | W12 | p | BL | W12 | p | BL | W12 | p | |
6 min Walking Test | |||||||||
Distance (m) | 642 (605–715) | 730 (695–830) | <0.0001 | 620 (590–701) | 700 (660–807) | <0.0001 | 684 (634–724) | 792 (714–850) | <0.0001 |
HRmean (bpm) | 119 (107–132) | 137 (116–152) | <0.0001 | 118 (107–135) | 128 (116–154) | 0.0003 | 121 (107–133) | 138 (116–153) | 0.004 |
HRmean (%HRmax) | 69 (63–75) | 73 (63–75) | <0.0001 | 69 (59–75) | 71 (63–83) | <0.0001 | 69 (63–75) | 75 (68–79) | 0.0005 |
Δ[La−] (mmol/L) | 0.9 (0.2-2.2) | 1.9 (0.5-4.1) | n.s. | 0.8 (0.0-2.3) | 1.2 (0.5-2.6) | n.s. | 1.0 (0.6-2.1) | 3.3 (0.7-4.5) | n.s. |
Δ RPE | 1.0 (0–1) | 0.5 (0–2) | n.s. | 0.5 (0.0-2.0) | 0.5 (0.0-0.2) | n.s. | 1.0 (0.0-1.0) | 0.5 (0.2-2.0) | n.s. |
1-RM and 30-s crunch tests
Body composition
All | Walk | Strength-Walk | |||||||
---|---|---|---|---|---|---|---|---|---|
BL | W12 | p | BL | W12 | p | BL | W12 | p | |
Anthropometrics | |||||||||
Weight (kg) | 75.0 (65.0-79.0) | 72.5 (63.3-77.8) | 0.0003 | 74.0 (62.0-78.5) | 71.0 (60–77) | 0.0001 | 76.0 (71.0-81.0) | 75.0 (71.5-79.5) | n.s. |
BMI (kg/m2) | 25.6 (22.2-27.2) | 25.0 (21.5 -26.9) | 0.004 | 25.3 (21.6-27.5) | 24.9 (21.2-27.0) | 0.001 | 25.8 (24.1-26.9) | 25.0 (23.9-27.0) | n.s. |
Waist Circumference (cm) | 93 (86–102) | 92 (84–99) | 0.050 | 93 (82–102) | 92 (83–100) | 0.046 | 94 (88–100) | 92 (88–98) | n.s. |
Hip Circumference (cm) | 95 (91–99) | 94 (90–98) | 0.040 | 97 (92–100) | 95 (90–100) | n.s. | 92 (91–99) | 92 (89–97) | n.s. |
Leg Circumference (cm) | 53 (49–57) | 53 (49–56) | n.s. | 53 (47–56) | 52 (48–55) | n.s. | 53 (51–58) | 53 (50–57) | n.s. |
Waist-to-hip ratio | 0.98 (0.92-0.95) | 0.98 (0.95-1.03) | n.s. | 0.96 (0.90-0.93) | 0.96 (0.93-1.00) | n.s. | 1.03 (1.01-1.03) | 1.02 (1.00-1.05) | n.s. |
DEXA | |||||||||
Total Fat (Kg) | 17.74 (12.52-22.85) | 17.66 (9.28-22.41) | n.s. | 20.73 (10.07-27.79) | 21.48 (9.44-28.94) | n.s. | 17.58 (16.16-19.19) | 17.52 (10.20-18.38) | n.s. |
Total Lean (Kg) | 50.88 (47.06-58.23) | 52.64 (46.38-57.90) | n.s. | 49.52 (38.27-57.55) | 48.43 (38.19-57.25) | n.s. | 58.22 (50.86-58.24) | 57.84 (52.66-59.93) | n.s. |
Total BMC (Kg) | 2.60 (2.38-2 95) | 2.59 (2.35-2.93) | n.s. | 2.49 (2.01-2.91) | 2.55 (2.30-2.91) | n.s. | 2.82 (2.51-3.08) | 2.85 (2.48-3.02) | n.s. |
Total BMD | 1.15 (1.06-1.21) | 1.15 (1.06-1.22) | n.s. | 1.14 (1.05-1.2) | 1.13 (1.03-1.21) | n.s. | 1.20 (1.13-1.20) | 1.19 (1.07-1.23) | n.s. |
Total Fat (%) | 25.6 (21.5-33.3) | 25.8 (16.7-32.2) | n.s. | 28.1 (20.1-37.4) | 26.9 (16.7-37.2) | n.s. | 24.0 (22.3-27.1) | 23.2 (16.5-26.4) | n.s. |
Laboratory examinations
All | Walk | Strength-Walk | |||||||
---|---|---|---|---|---|---|---|---|---|
BL | W12 | p | BL | W12 | p | BL | W12 | p | |
Total Cholesterol (mg/dL) | 196 (163–236) | 186 (162–215) | 0.018 | 190 (157–229) | 180 (151–214) | 0.042 | 217 (174–237) | 191 (165–232) | n.s. |
HDL-Cholesterol (mg/dL) | 46 (34–54) | 47 (36–56) | n.s. | 45 (34–55) | 47 (35–56) | n.s. | 46 (33–56) | 45 (35–59) | n.s. |
LDL-Cholesterol (mg/dL) | 124 (106–155) | 108 (93–139) | 0.004 | 116 (96–148) | 103 (89–138) | 0.033 | 147 (120–164) | 121 (106–144) | 0.031 |
Triglycerides (mg/dL) | 143 (111–201) | 131 (93–200) | n.s. | 142 (101–222) | 112 (80–205) | n.s. | 137 (107–210) | 165 (121–283) | n.s. |
Glucose (mg/dL) | 85 (78–92) | 82 (79–93) | n.s. | 85 (74–92) | 81 (79–92) | n.s. | 86 (80–93) | 82 (78–93) | n.s. |
Insulin (mg/dL) | 11.8 (7.9-16.5) | 13.0 (8.0-16.9) | n.s. | 10.2 (5.8-17.0) | 13.8 (6.6-17.2) | n.s. | 13.1 (9.9-15.2) | 10.3 (8.6-18.8) | n.s. |
HOMA-Index | 2.8 (1.6-3.4) | 2.7 (1.7-4.1) | n.s. | 2.3 (0.9-3.7) | 2.8 (1.2-4.1) | n.s. | 3.0 (2.1-3.3) | 2.3 (1.8-5.0) | n.s. |
HbA1c (%) | 5.3 (5.1-5.8) | 5.5 (5.3-5.6) | n.s. | 5.2 (5.0-5.7) | 5.3 (5.1-5.6) | n.s. | 5.5 (5.3-5.9) | 5.5 (5.5-6.0) | n.s. |
CD4+ T-cells/μL | 577 (407–726) | 559 (445–715) | n.s. | 485 (365–686) | 557 (365–684) | n.s. | 642 (527–740) | 587 (481–796) | n.s. |
CD8+ T-cells/μL | 821 (652–914) | 747 (566–975) | n.s. | 766 (581–872) | 743 (632–950) | n.s. | 916 (783–1349) | 747 (561–1090) | n.s. |
VACS index | 12 (5–19) | 12 (0–21) | n.s. | 16 (6–24) | 17 (3–22) | n.s. | 9 (0–12) | 10 (0–18) | n.s. |